WASHINGTON — Eugene Passer had never heard of the turbinates, a set of tissues that lie in the nasal cavity. Then a doctor removed much of them, he says, and life became a mess.
A New York college professor, Passer says he can no longer teach organic chemistry labs because he cannot detect the smell of dangerous fumes. Head and eye pains are constant. On cold days, the air leaves him dizzy and weak. He rarely travels anywhere without a humidifier, which eases some of his symptoms.
"I'd say a large part of my life has been destroyed--it's that simple," Passer said.
Now, sinus specialists are engaged in a contentious debate about what causes the problems reported by Passer, and by a small but increasingly vocal set of other patients. At professional conferences, one group of physicians has been trying to build a case that removal of too much turbinate tissue can cause an illness the doctors call "empty nose syndrome," which they say has appeared only in recent years.
Other specialists doubt that the syndrome exists. They say that turbinates have been removed for 100 years with few problems and that the pain patients report must come from some other cause.
The debate may sound arcane, but more than 160,000 people had turbinate tissue removed in 1996, the last year for which the Centers for Disease Control and Prevention has statistics. Some doctors think that the true number is far higher, and that it is rising.
People who think they have empty nose syndrome say it was a variety of complaints that initially prompted them to see a doctor. A few had structural problems in the nose, such as a deviated septum. Some had nasal growths, or polyps, that had to be removed. Most were seeking relief from the headaches and breathing problems that often come from sinus inflammation, a common complaint that accounts for nearly 10.8 million doctor visits each year, more than for asthma and about the same as for ear infections.
But these patients claim that the real trouble started after a doctor treated them by removing turbinate tissue, most often in an attempt to make breathing easier.
Now, Tom Brown, a New York businessman, says he feels like he has a permanent case of the flu. Bradley Santos, a federal worker in Washington, D.C., complains of headaches, and he says he has lost his senses of smell and taste.
